ABSTRACT
OBJECTIVE: It consisted in evaluating the cardiovascular risk factors and the overall cardiovascular risk among the personnel of the company of the breweries of Mali. METHODOLOGY: This was a cross-sectional, descriptive, analytical study. It was conducted from November 2020 to May 2021 as part of routine consultations and periodic medical visits. The overall cardiovascular risk was estimated by the new Framingham model and the WHO/ISH predictive diagram. RESULTS: A total of 257 workers were included. The average age was 41.2 years. Cardiovascular risk factors listed were, smoking (18.7%), hypercholesterolemia (17.1%), obesity (15.6%), alcoholism (8.6%), age over 50 years (14%).Work-related cardiovascular risk factors were also collected. These were the practice of shift work (58.8%), exposure to noise (44%), sedentary behavior at the workstation (25%). The risk of developing cardiovascular disease in the next 10 years was high in 3.11% and very high in 0.78% of respondents. CONCLUSION: This study highlights several cardiovascular risk factors, some of which are specific to the professional environment. The implementation of preventive measures is a necessity.
BUTS: Il consistait à évaluer les facteurs de risque cardiovasculaire et le risque cardiovasculaire global chez le personnel de la société des brasseries du Mali. MÉTHODOLOGIE: Il s'agissait d'une étude transversale, descriptive, à visée analytique. Elle a été menée de novembre 2020 à mai 2021 dans le cadre des consultations de routine et des visites médicales périodiques. Le risque cardiovasculaire global a été estimé par le nouveau modèle de Framingham et le diagramme prédictif de l'OMS/ISH. RÉSULTATS: Au total, 257 travailleurs étaient inclus. L'âge moyenétait de 41,2 ans. Les facteurs de risquecardiovasculaire répertoriés étaient, le tabagisme (18,7%), l'hypercholestérolémie (17,1%), l'obésité (15,6%), l'alcoolisme (8,6%), l'âge supérieur à 50 ans (14%). Des facteurs de risque cardiovasculaire liés au travail étaient également colligés. Il s'agissait, de la pratique du travail posté (58,8%), de l'exposition au bruit (44%), de la sédentarité au poste (25%). Le risque de développer une maladie cardiovasculaire dans les 10 ans à venir était élevé chez 3,11% et très élevé chez 0,78% des enquêtés. CONCLUSION: Cette étude met en évidence plusieurs facteurs de risque cardiovasculaire dont certains spécifiques au milieu professionnel.La mise en place de mesures de préventionest une nécessité.
ABSTRACT
PURPOSE: To evaluate the RARE (Réseau Action-Recherche sur l'Epilepsie) program, a model of managing and treating people with epilepsy (PWE) at a primary health-care level in rural areas of Mali, we assessed treatment efficacy and compliance of patients who underwent the first year follow-up. METHODS: A network of rural general practitioners (GPs) settled in six rural districts of the regions of Koulikoro, Segou and Sikasso, was involved in the diagnosis, evaluation and monitoring of all the identified PWE and in the distribution of phenobarbital (PB). All the participants were included in a prospective database and followed-up by GPs at 4 months intervals during the first year. Seizure frequency, treatment doses and appearance of adverse events (AEs) were systematically recorded. Efficacy was evaluated in terms of reduction of seizures frequency while noncompliance in terms of time to study withdrawal for any cause. KEY FINDINGS: 596 patients treated with PB were included in the analysis. Of these, 74.0% completed the first year follow-up. At the final visit, 59.6% were seizure-free: 31.0% for 12 months, 10.2% for 8 months and 18.4% for 4 months. Adults and patients with convulsive seizures were the most drug-resistant (p<0.002). Few AEs were recorded. The multivariate analysis showed that being a woman, presenting convulsive seizures, having more than 5 seizures/month and had never be treated were predictors of withdrawal (p ≤ 0.05) at 12 months. SIGNIFICANCE: This study showed a good response and compliance to the treatment and allowed the identification of some factors associated with failure of management in a setting very near to clinical practice. Awareness campaigns are needed to assure a broader accessibility to treatment and to improve the compliance and continuity with treatment programs.
